Effectiveness of antihypertensive treatment in patients with chronic kidney disease

J Ren Nutr. 2008 Jan;18(1):134-9. doi: 10.1053/j.jrn.2007.10.027.

Abstract

Objective: Hypertension is closely associated with chronic kidney disease (CKD) and is one of the main factors of progression of CKD. Early detection of CKD allows introducing a therapy that slows the progression of CKD.

Setting: A prevalence of hypertension and effectiveness of its treatment were assessed during the accomplishment of the Program for Early Detection of CKD in Poland (PolNef).

Results: In 456 of a total of 2476 participants of PolNef program (269 females, 187 males), CKD was recognized. Diagnosis of CKD was made according to classification proposed by K/DOQI and KDIGO. Estimated glomerular filtration rate (eGFR) from serum creatinine, albuminuria and ultrasound examination were the main diagnostic tools. Hypertension was defined on the basis of actual antihypertensive treatment or on the basis of medium value (> or = 140 and/or > or = 90) of three separate measurements of blood pressure. Frequency of hypertension and effectiveness of its treatment, frequency of overweight and obesity, microalbuminuria, and abnormalities in ultrasound examination of urinary system were studied.

Conclusion: Of the CKD population, 68% were hypertensive, 21% remained without antihypertensive medication, and 22% on medication were effectively treated. Kidney insufficiency with eGFR below 60 ml/min/1.73 m2 was recognized in 9% of CKD population. Also, 63% of women and 39% of men without hypertension had normal body mass compared to 19% of people with CKD and hypertension. Microalbuminuria was found in 51% of women and 66% of men with CKD and hypertension. Increased echogenicity of kidney and simple cysts were detected significantly more often in hypertensive patients.

MeSH terms

  • Adolescent
  • Adult
  • Aged
  • Aged, 80 and over
  • Antihypertensive Agents / therapeutic use*
  • Body Mass Index
  • Female
  • Humans
  • Hypertension / drug therapy*
  • Hypertension / epidemiology
  • Kidney Failure, Chronic / complications*
  • Male
  • Middle Aged
  • Poland
  • Prevalence

Substances

  • Antihypertensive Agents